články -patopsychologie

Moreover, research on the relationship between sex and PTS indicates that females are more likely to suffer from trauma-related symptoms following childhood maltreatment (Keller, Salazar, & Courtney, 2010; Tolin & Foa, 2006). It has been suggested that females are more likely to ruminate following traumatic events, which increases their risk of developing trauma-related disorders (Ehlers & Clark, 2000). Moreover, females are at greater risk for sexual victimization in childhood (Dube et al., 2005), which has been strongly associated with the development of PTS (Tolin & Foa, 2006).

With respect to other demographics, such as ethnicity, research findings are mixed. Several studies suggest that, relative to their Caucasian counterparts, African American adolescents in child welfare typically exhibit fewer problem behaviours (Keller et al., 2001) and receive fewer mental health services (Garland, Landsverk, & Lau, 2003; Leslie, Hurlburt, James, Landsverk, & Slymen, 2005). Other studies, however, have not found any ethnic differences with regards to self-reported PTS (Keller et al., 2010, Kolko et al., 2010).

Research has also explored several child welfare-level predictors of psychological functioning, including the type of placement and number of placements. Compared to children living with their biological parents, children who are placed in non-kinship foster care or group homes show significantly higher rates of psychological difficulties (Burns et al., 2004, Keil and Price, 2006). Moreover, significantly more maltreated children in out-of-home care exhibit heightened PTS symptoms compared to those children who experienced maltreatment but remained in their homes (Kolko et al., 2010). In addition, research indicates placement instability is almost universally considered disadvantageous to children (Barber & Delfabbro, 2003). Multiple placements are associated with multiple school changes, difficulty maintaining attachment bonds with caregivers, and building new relationships within the home, school, and community (Barth et al., 2007). A greater number of placements have also been associated with more severe trauma symptoms among maltreated youth (Raviv, Taussig, Culhane, & Garrido, 2010).

Although extensive research has examined the well-being and functioning of child-welfare-involved adolescents, such studies have tended to rely on variable-centered approaches that describe the average behavior of a sample (Laursen & Hoff, 2006). While variable-centered analyses are informative, they underscore the importance of inter-individual variation. In contrast, person-centered mixture model approaches model population heterogeneity and identify distinctive subgroups or “profiles” of individuals within a sample that have similar psychological presentations (Laursen & Hoff, 2006). Hence, such analyses can provide a greater understanding of the diversity of psychological outcomes among maltreated adolescents in care.

Several person-centered research studies have attempted to identify subgroups of adolescents based on trauma-related symptomatology in a variety of populations, including community-based samples (Ayer et al., 2011; Breslau, Reboussin, Anthony, & Storr, 2005), female sexual abuse survivors (Au, Dickstein, Comer, Salters-Pedneault, & Litz, 2013), and youth involved in the juvenile criminal system (Vaughn, Freedenthal, Jenson, & Howard, 2007). The number of profiles identified across these studies has ranged from three to four, with at least one profile depicting adaptive functioning and at least one profile depicting poor functioning across a range of trauma-related symptoms. Profiles indicators have included self-reported post-traumatic-stress disorder (PTSD) symptoms either alone or in combination with other psycho-social measures (i.e., depressive symptoms, substance use, problem behaviours).